The Nash County Health Department is investigating a possible foodborne illness outbreak in Nash County after 75 people reported becoming ill after eating at Ribeye’s Steakhouse in Nashville last week.

Two people were hospitalized after eating there and have been released, but it has not been confirmed whether their illnesses were associated with eating at the restaurant, said health department spokeswoman Amy Belflower Thomas.

The Rocky Mount Telegram reports she could not say what food dish at the restaurant, if any, might have caused the illnesses.

“Seventy-five people have called us and said they were sick or ate with someone who was sick, and gave me their names,” Thomas said. “It’s not like we’ve gone out and asked people to call us.”

Janice Manning, an owner of Ribeye’s Restaurant, said patrons can feel confident the food served is safe to eat.

“I just spoke to the health department recently,” she said. “I’ve not heard that anything was confirmed. They are working on it.”

She said the restaurant has been sanitized and all of the food that was there when the complaints were filed has been thrown out.

“We are probably the safest place in town (to eat),” Manning said.

She noted the restaurant has had consistently high grades from the health department on its sanitation report card.

The Nash County Health Department in North Carolina is investigating several reports of gastroenteritis that it says might be associated with Ribeye's Steakhouse off N.C. Highway 64 in Nashville.

Health officials started receiving calls late Thursday about the food poisoning, which they say has symptoms similar to a stomach bug, including nausea, vomiting and diarrhea. One person who could be connected to this case has been hospitalized.

Health officials said they do not know what type of organism caused the sickness, and test results could take days. They are still investigating to determine its origin.

"We have to look at some other things to make sure it's not a red herring, so we are pursuing that in our investigation too, to make sure the link is true," said Amy Bellflower-Thomas of the Nash County Health Department.

The owner of the restaurant said she was "devastated," and wasn't sure how people could have gotten sick after eating there. As a precaution, she said staff was disinfecting the entire restaurant. 

A North Carolina maker of fermented bean product confirmed Monday evening that its product tested positive for salmonella. as an outbreak caused by the bacteria worsens.

Smiling Hara Tempeh, which makes a soy, black bean and black-eyed pea version of the product, according to its website, had pulled the food from shelves earlier Monday.

The Asheville Citizen-Times reports that tests by the N.C. Department of Agriculture confirmed the bacteria was present in a sample collected from a routine inspection by the Food and Drug Protection Division, according to a statement from Smiling Hara Tempeh. Further testing is being done, it added.

The tempeh is sold to more than 30 local stores and restaurants, including Earth Fare supermarket and the Laughing Seed restaurant downtown, the website says.

The number of salmonella cases rose by five over the weekend to 34, officials with the Buncombe County Health Department said Monday.

The owners of the tempeh company, which lists its address as Asheville, could not be reached by phone or email Monday afternoon.

The tempeh company shares a kitchen, Blue Ridge Food Ventures in Candler, with 20-40 other local food producers, making everything from pretzels to hot sauce.

The state-created economic development group Advantage West oversees the kitchen used to help small local businesses.

Advantage West CEO Scott Hamilton stressed that there was no direct link with the tempeh and the bacterial outbreak.

Uh-huh.

My initiation into the real world of food production was in the vegetable production industry. As a 22-year-old naive graduate student Doug sent me out to Leamington Ontario (that's in Canada) with Amber Bailey, to see whether I could work with greenhouse producers on keeping their wash water and employee's hands clean. That trip turned into a MSc project and I spent three years working with almost 200 farmers on risk-reduction practices as I took product and water samples.

On one of those visits a farmer wanted to talk about food safety regulations, especially whether farms would ever see the type of regulation restaurants do. He said that a law might help provide some uniformity to how farmers managed risk and could provide a level playing field (because even in 2002 they were seeing inconsistent audits/auditors) but he finished by saying something like, "I don't really want to be regulated like restaurants, with inspectors who have never been on a farm sniffing around here looking for problems."

My experience on the farms (and then in restaurants) also taught me that getting someone to change what they do is a lot easier if you can describe the evidence behind the new practice. Telling folks about outbreaks and data in a compelling way matters.

The folks I encounter regardless of sector, still ask a lot of questions about the whys behind a particular rule or guidance.

Later this year, according to Thomas Goldsmith of the News & Observer, North Carolina will be adopting the FDA Model Food Code by reference - which means the state's food service rules will be based on the best available science, will update automatically with subsequent versions of the code.

A useful food safety regulation has a nod to risk calculations (probability and consequences) and is built on some sort of evidence (whether that be strong outbreak investigation data or laboratory data). The FDA model food code, for the most part, fits this.

The Model Food Code also provides the best example of how to systematically evaluate the times, temperatures and practices and make recommendations for revision when new information comes up (the biannual Conference for Food Protection provides this nice framework).

Cold food will have to be kept colder. Restaurant employees who have certain symptoms won’t be allowed to work. And cooks won’t touch ready-to-eat food with bare hands, but only with gloves, deli paper or tongs.

These are just a few of the changes that will accompany North Carolina’s expected adoption of federal Food and Drug Administration guidelines that will replace a much-amended set of regulations dating from 1976, state and local officials said.

Developed by the FDA in collaboration with scientists, academics, industry representatives and physicians, the Food Code is revised every four years based on the most up-to-date science available, said Larry Michael, head of the food protection program at the state division.

“The approach in the past involved an endless process of revising the rules and standards,” Michael said. “This proved to be inefficient.

A 2010 survey in Wake County reinforced the need for new guidelines, said Andre Pierce, environmental health and safety director for county environmental services. About 90 percent of restaurants and other food-service places didn’t have the kinds of policies to keep sick workers home that are included in the federal code.

Physical conditions that rule out working in food service are diarrhea, vomiting, sore throat with fever, jaundice and lesions with pus.
Some provisions, such as keeping cold food at 41 degrees instead of 45 degrees, will be phased in to give restaurants time to comply. The code also will require that every establishment have a certified food-safety manager on site at all times.

The state estimates that compliance will cost the food service industry $5.5 million during the first four years but that restaurants and other establishments will realize benefits that can’t be quantified from not making people sick. Industry figures state that an outbreak of foodborne illness costs a restaurant an average of $75,000.

Meanwhile, during the same four-year period, the state is expected to save $6 million compared to current costs of dealing with such outbreaks.

Given repeated, widely publicized incidents of foodborne illness, many restaurants already follow the provisions of the FDA code, said Alyssa Barkley, director of health and safety for the North Carolina Restaurant and Lodging Association. “I have been at the table for a couple of years throughout this process,” said Barkley, whose background is in public health. “We have been at the table making sure that the rules that are adopted aren’t going to be a major burden on businesses.”